New Dental Technology

I spent the last two days attending Esthetic Professionals 10th Annual Update course. This is the third or fourth Esthetic Professionals update course I have attended. It was highly informative on the latest and greatest in dental technology and materials. Also, I had the pleasure of hearing Dr. Bill Dorfman speak as well as a dental materials educater from Loma Linda School of Dentistry, Dr. Brian Novy.

The most exciting new technology presented at the meeting is 3M ESPE's new digital scanner called the LAVA COS. The scanner can image a tooth in the mouth that has been prepared for a crown. The scanner is a mix between a video camera and a still picture camera. It moves around like a video while at the same time plotting 20,000 picture points. These picture points are so accurate that the image can be used to fabricate a model that can be used to make the final crown restoration.

Dr. Bill Dorfman spoke about an electronic oral cancer detection system call VELscope. Apparently, the light emitted from the Velscope shows any cancerous or precancerous lesions as black tissue. Twenty-five percent of oral cancers occur in people that have no obvious risk factors such as a history of smoking or excessive alcohol consumption.

Dr. Brian Novy presented some convincing clinical work he has done to remove decalcified white spots caused by braces. The treatment for the white spots involves wearing custom plastic trays that are similar to bleaching trays, along with a calcium-phosphate-fluoride paste called MI paste. These trays are worn for about a month and the white spots nearly disappear.

It is always fun to learn about new technologies and procedures. The hard part is deciding which technologies to bring back to your office.

Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com

Conquering the two year old patient

In the past two weeks I have seen three patients in the two year old age range. The biggest challenge with patients in this age group is getting them to open their mouths and to stay open while you look in their mouth. I asked my son's pediatrician the other day why it is that one and two year olds don't like to open their mouths. His response was that the mouth is the one thing a child that age can control. Apparently you can put your fingers in the child's ears and eventually they will open their mouth to get you to remove your fingers. While this trick might work for the pediatrician that is just trying to take a quick look in the back of the throat, it doesn't work so well for the dentist that needs to evaluate 20 individual teeth.

Back to my story... I saw three such patients recently. The first one was a girl that was turning two in a couple of weeks. She didn't want to have anything to do with me and refused to even open her mouth. The second child I saw was a girl that had just turned two. I tried a different approach with her. First, my assistant found a cartoon on television for the girl to watch. Then I had the mom hold the daughter in her lap while we counted the mom's teeth. After we counted the mom's teeth, the little girl wanted her teeth counted as well. While counting the teeth I am able to evaluate each individual tooth for cavities. By two years of age nearly all twenty of the baby teeth have erupted. If cavities are present at this age, then they are either visually evident or are apparent when touching the tooth with a dental explorer (an instrument with a pin like end).

The third patient I saw was a three year old boy. In his case both the cartoon trick and counting daddy's teeth worked. As a three year old there was a little bit more comprehension of what was going on and I was able to polish his teeth as well.

Fortunately, in all three cases the children's parents were doing a good job assisting with the brushing and none of the children had any cavities. When kids this age do get cavities the only way to treat them is to either wait until the child is older (like age four or five) or to treat them while the child is under anesthesia. The best thing for the two and three year old patient is cavity prevention!
Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.familycaredentists.com

Sleep and Babies

Time Magazine online published an article today on "How Not to Get Babies to Sleep." My husband lovingly emailed me the link to the article this morning. This article is particularly poignant to me right now since I haven't slept much lately. My son is ten months old today and he has slept through the night only once in ten months.

According to the article, "Every new parent knows how difficult it can be to get a fussy baby to sleep, but new research suggests that a parent's best efforts may only be exacerbating the problem — and that inadequate sleep in childhood can have long-lasting health effects. "It is very hard to let your child cry it out when they are toddlers," says Dr. Elsie Taveras of Harvard Medical School, referring to parents' tendency to pick up their children or bring them into the family bed to help them sleep. "But if you approach it differently — 'I am not even going to start my child making these sleep associations' — it's much easier to prevent [future problems]."

It is wonderful to know that in addition to the fact I am struggling with making my son sleep in his own bed, through the entire night, I now need to worry about the long-lasting health effects of his poor sleep habits. Before my son was born I swore I would encourage good sleep habits and that he would be sleeping through the night in no time. I read Baby Wise and Healthy Sleep Habits, Happy Baby. In line with the thinking in those books I have tried to be consistent with a bedtime, nap times, and feeding times. I have tried a bedtime routine of bath time, reading, and feeding. I have let him cry himself to sleep since he was three months old.

The problem seems to be when he wakes up at 1, 2, 3 or 4 in the morning and I am totally exhausted. My first inclination is to feed him. Although at this age I don't think he is really hungry in the middle of the night. Sometimes I let him sleep with me in an effort to get some sleep myself. I feel like I am doing everything wrong when it comes to getting him to sleep through the night. At this point in time I think I am almost encouraging the night time waking because I am SO attentive to his needs.

Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.dentist4smiles.com

How to choose a dentist

My husband and I recently had to find a contractor in Portland, Oregon, while we live in southern California. Since we didn’t have the benefit of having a word of mouth referral, we turned to the internet to search for one. I happened upon a web based company that acts as a referral source for contractors. The referral company gave me the contact information for three supposedly “pre-screened” and “excellent” contractors. In the process of speaking with one of those contractors I asked how he became part of that company’s referral network. He said that he had to pay 50 dollars for each referral that was sent his way. So, if a contractor pays to be part of a referral network, then are they truly prescreened and excellent at what they do?

After my experience of looking for a contractor, I started thinking about how I would choose a dentist if I was new to an area and had no idea where to go.

There are a couple of ways I would not look for a dentist. For instance, I would not even bother to contact a dental referral service such as 1-800-DENTIST. To be a prescreened member of that service, the dentist pays nearly $2000 per month. Also, I don’t think I would look in the phone book due to the limited amount of information in a print ad.

The first thing I would do is an online search for local dentists in my area, using a search engine such as Yahoo local pages, google, or superpages. Then I would look over the websites of the various dentists that came up in my area. Most websites provide a pretty good look and feel of the dentist, the practice scope, hours office is open, emergency patient information, insurance plans accepted, and payment plans.

All 50 U.S. states individually license their dentists. In California you can do a search on the dental board’s website for a dentist’s license. The website will tell you how long a dentist has been licensed, the status of the license, and if there are any outstanding complaints against them.

Another avenue I might consider in finding a dentist is calling an oral surgery office and asking for a referral. There are usually a limited number of such offices and they will have contact with a large number of the general dentists in town.

Finally, I would call any potential dentists I was interested in seeing, to ascertain the availability of appointments and whether or not the dentist makes patients wait. I want to know that if I ever were to have a dental emergency that the dentist would be able to see me relatively soon.

In my office, we try and see all new patients within two weeks of their initial phone call. We almost always run on time, because I can’t stand to make people wait. And when someone has an emergency I see them the same day. If a patient has an emergency over a weekend then I am available via my pager. Lately, I have been receiving quite a number of new patients over the internet that have seen my website or seen a review of my practice. The internet definitely has a wealth of information!

Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.dentist4smiles.com

bonding versus veneers

Sometimes in dentistry there are a couple of ways of achieving a similar aesthetic result. Bonding with tooth colored composites or cementing on porcelain veneers are two such techniques that can be used to fix the size and shape of teeth. Deciding which method to use can be confusing because there are advantages and disadvantages to each.

Bonding with tooth colored composites is a relatively inexpensive, reversible procedure that can be used to fix chipped teeth or to close gaps between teeth. In order to bond composite to the tooth surface, the tooth is micro-etched, a bonding agent is light cured to the surface, and then the composite material to light cured over the bonding agent. This is usually a completely additive process and it is done directly in the office. The general cost for this procedure is between $150 and $500 per tooth, depending on the size of the restoration required.

Porcelain veneers are a more costly procedure involving two appointments about two weeks apart. Teeth are slightly prepared to accommodate the size of a porcelain shell, an impression of the prepared teeth is taken, and a dental laboratory makes a thin layers of porcelain for each tooth. The veneers are permanently cemented to the teeth. The cost for a porcelain veneer ranges anywhere from $1000 to $2000 per tooth, depending on the dental office.

Basically, if teeth have small chips or gaps, but no other issues, then bonding with composites makes good economic and long term sense for the health of the tooth. However, if the teeth have color, rotation, or crowding issues, then porcelain veneers allow for more flexibility and better aesthetic results. Porcelain veneers can be used in nearly any instance that bonding would be appropriate. Bonding cannot fix all the things that veneers can transform. To know which would work best for you, collaborate with your dentist!

Kari Ann Hong, DDS
1000 Newbury Road, Suite 190
Thousand Oaks, CA 91320
www.dentist4smiles.com